The present invention relates to aggregation of human platelets. More particularly, the invention relates to a method of inhibiting thrombin or ADP-induced fibrinogen aggregation of human platelets as well as the construction of a synthetic platelet aggregation inducing molecule.
A number of different mechanisms have been disclosed which lead to the aggregation of human platelets to initiate blood clots (thrombi). One such mechanism is the thrombin or ADP-induced platelet aggregation cross-linked by the multivalent molecule, fibrinogen. Thrombin and ADP induce modification of the platelet structure, allowing interaction between platelets and fibrinogen to form aggregates. While the exact mechanism is not clear, one theory for this interaction is that thrombin and ADP cause a stereochemical change of the glycoprotein structure of the platelet cell membrane. The stereochemical change appears to create the specific receptor site on the platelet so that platelet binding regions on the fibrinogen molecule can react with this receptor site to form the aggregate. Until recently, the location of the platelet binding regions of human fibrinogen were unknown. In 1982, Hawiger, Timmons, Kloczewiak, Strong and Doolittle demonstrated that the primary fibrinogen interaction site with human platelets is located on the gamma chain of fibrinogen. See Proc. Natl. Acad. Sci. USA 79:2068-2071 (1982). In a later paper, Kloczewiak, Timmons and Hawiger demonstrated that the platelet binding region on fibrinogen was contained within the carboxyl terminal 27 peptide residues of the gamma chain and that a 15 peptide carboxyl terminal fragment of this molecule could block fibrinogen platelet aggregation. See Biochem. and Biophy. Rsc. Comm. 107:181-187 (1982).
Fibrinogen is important in the formation of hemostatic platelet plugs and initiation of thrombotic lesions. Blockage caused by these plugs and the damage caused by thrombotic lesions are major factors in heart disease and stroke. Much research has been directed toward developing drugs which will dissolve already formed blood clots but most of these drugs have not been particularly effective. Recently, reports on the use of tissue plasminogen activator, a molecule which modifies circulating plasminogen molecules to form plasmin, an enzyme that dissolves blood clots, have been given much publicity. While enzymatic methods of dissolving clots may help minimize the after effects of heart attacks, a pharmaceutical preparation which will inhibit platelet aggregation prior to occlusion of the blood vessels may prevent the initial blockage responsible for cardiac or cerebral infarction.
Alternatively, platelet aggregation promoting molecules may have a variety of uses. For example, a number of patients, e.g., some bleeders, may be lacking fibrinogen due to a genetic deficiency or due to excessive consumption in circulation. A synthetic platelet aggregating molecule can promote platelet plug formation to arrest bleeding and help these patients to lead normal lives.
Accordingly, an object of the invention is to develop a method of inhibiting thrombin or ADP-induced fibrinogen aggregation of human platelets. Another object of the invention is to provide a molecule which promotes thrombin or ADP-induced platelet aggregation. A further object of the invention is to provide a synthetic molecule which inhibits thrombin or ADP-induced fibrinogen platelet aggregation with significant circulation time in the blood stream. These and other objects and features of the invention will be apparent from the summary, the drawing and the description.